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A conversation with Hasan Alam, MD, of "Boston Med"

SPOTLIGHT ON TRAUMA SURGERY: Screenshots of episode six featuring Alam

HASAN ALAM, MD, of the Division of Trauma, Emergency Surgery and Surgical Critical Care and director of the Surgical Critical Care Fellowship at MGH, starred in the sixth episode of "Boston Med." In the episode, he performs emergency surgery on 42-year-old Patrick Coleman, who fell off a ladder while fixing a roof. The eight-part ABC series, which features staff, patients and families at the MGH, BWH and Children's Hospital, came to an end Aug. 12. Below, Alam answers some questions about his work and "Boston Med."

Q. How did you decide to become a doctor?

A. I knew early on that I wanted to be a physician, though I didn't know I wanted to be a surgeon until I went to medical school. Being a surgeon was very attractive because it is a goal-oriented, definitive field. I wanted to be in a field where I could tangibly fix things. In trauma surgery, most of the time, if you do the right thing, your patients can walk out of the hospital and have normal, productive lives.

Q. What is the most challenging part of your job?

A. The most challenging part of the job is making quick decisions about critically injured patients. These life-and-death decisions often have to be made with an incomplete set of data – you don't have the luxury of time to gather all the needed information, review it, consult with your colleagues, look at the pros and cons (there are always different ways to approach a problem), and then choose the best approach and discuss it fully with your patient.

Q. What was it like to be filmed by ABC crews while working?

A. It was actually much easier than I thought it would be. Early on it was a little awkward – wearing a microphone and having a camera follow you around – but I got to know the crew members, and they were all nice and fairly nonintrusive. After a few days, filming became fairly routine.

Q. Where did you watch the episode you were featured in? What did you think of it?

A. I watched it with my wife at home. ABC did a good job – it's hard to cover a complicated story in a short period of time. They didn't really focus on how Patrick had to stay in the hospital for months and had a relatively long and complicated path to recovery. There were numerous teams involved – including the surgical residents who did an amazing job from the moment the patient came in the hospital's doors, to the people who helped with his postoperative and rehabilitative care. Other surgeons, multiple specialists, residents, nurses and intensive care unit staff played significant roles.

Q. Is there anything else you'd like to add to what was portrayed in the episode?

A. Unfortunately, every time there's a war, the field of trauma benefits, as we learn new approaches for things like resuscitation and hemorrhage control, emergency surgeries and rehabilitation techniques. The Office of Naval Research, the Defense Advance Research Project Agency and the U.S. Army Medical Research and Material Command don't get enough credit for the enormous support they provide for trauma research. It is due to the support of such agencies and the heroic efforts of military physicians that the care of the injured has been revolutionized on the battlefields of Iraq and Afghanistan. Many of these innovations have already been adopted by the civilian trauma community and are saving lives every day, including the life of Patrick, the patient shown in this episode.

Q. Compared to other similar cases you've had, how severe was Patrick's situation?

A. He was not the most severe case, but he was extremely sick. Although he was bleeding at multiple sites and his blood pressure was extremely low, he was still alert and talking to people, which was very deceptive. Based on the fact that he fell 15 to 20 feet, which isn't a terrible fall, and because he was alert and conversant, he didn't look like someone who had lethal internal injuries. In reality, he was minutes away from a complete collapse, and we made the decision to bypass any additional tests in favor of an emergency operation.

Q. Have you seen Patrick since surgery?

A. Only during the routine follow-ups, and I've gotten some reports on him and know that he's doing okay. In surgery and more specifically in trauma surgery, as a general rule, you want the patients back in society living their normal lives without any need for long-term follow up. Our role is to support them through a tough period, and if they never need us again, I consider it a job well done.

For more information on "Boston Med" and other interviews with featured MGHers, visit www.massgeneral.org/bostonmed.